Trust is an important psychological factor in social life for individuals. In persons with autism spectrum disorder (ASD), social communication skills, including trust of other people, is often impaired. The purpose of this study is to assess the effects of autistic traits and the presentation of stylized eyespots on performance of the ultimatum game, which examines human altruistic behaviors. Autism spectrum Quotient (AQ) and Trust score by Yamagishi et al. were used as measures of psychological variables. The subjects of the present study included 26 healthy adults. In the ultimatum game, when stylized eyespots are presented on a computer screen, subjects distribute more money. The AQ scores and the amount of distributed money showed a positive correlation. But the trust scores and the amount of distributed money did not show a significant correlation. Our results indicated that subjects tended to take on altruistic behavior in the ultimatum game, when eyespots were presented, and that autistic traits were associated with performance in this game.

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The melting behavior of histamine was investigated by AC calorimetry. The sample consisted of both crystalline solids, with regular ordered arrays of components held together by uniform intermolecular forces, and amorphous solids, which are not arranged in regular arrays. The melting point of histamine was about 84℃. The specific heat became a frequency-dependent complex quantity at and around the melting point. The specific heat was determined to be a “dynamic” specific heat. The frequency dependence of the measured dynamic specific heat was described by the Debye relaxation function. With temperature increases, the relaxation time became faster, from 28s to 7s. This indicated that the progress of the melting transition was slow and that the intermolecular force was strong. At temperatures below the melting point (61℃-67℃), we observed a thermal anomaly. Therefore, it was considered that both endothermic and exothermic reactions occurred in the amorphous solids.

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For patients with cleft lip and palate, we take maxillary plaster models prior to performing cheiloplasty at age 3 months and palatoplasty at age 1 year at our institute. We evaluated the posterior width of the alveolar cleft margin to ascertain the effect of closure of the anterior hard palate upon performing cheiloplasty. The subjects were 27 patients with complete unilateral cleft lip and palate whose appropriate maxillary plaster models were taken before cheiloplasty and palatoplasty. The patients were divided into 2 groups. The control group comprised 19 patients whose anterior hard palates were not closed. The comparison group comprised 8 patients whose anterior hard palates were closed by using a vomer flap. We measured the following: 1) the longer diameter of the entire alveolar arch, 2) the anterior, 3) medial, and 4) posterior width of the alveolar arch, 5) the posterior width of the alveolar cleft margin. There was no significant difference in these measurements between the two groups. The data indicated that closure of the anterior hard palate did not significantly disturb growth of the maxillary alveolar arch. We expected narrowing of the posterior width of the alveolar cleft margin by closing the anterior hard palate, but such a result was not obtained. However, closure of the anterior hard palate was easier when cheiloplasty was performed, rather than palatoplasty. It seemed that there would be significance in the partial closure of the anterior hard palate at the time of primary repair.

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Despite continued debate, the BRAF V600E mutation is a valuable prognostic factor in thyroid carcinoma. We aimed to use immunohistochemistry to detect BRAF (VE1), estrogen receptor (ER) and progesterone receptor (PgR) expression in thyroid tumors. Surgical specimens from 59 cases of thyroid Papillary carcinoma, 3 cases of thyroid follicular carcinoma, 3 cases of poorly differentiated thyroid carcinoma and 4 cases of undifferentiated thyroid carcinoma were collected between 2004 and 2014 at Showa University Hospital. As a benign lesion control, we used specimens from 46 cases of adenomatous goiter. Specimens were immunostained for BRAF (VE1), ER and PgR. The cutoff immunostaining intensity value for a positive BRAF (VE1) specimen was ≥ 2. ER and PgR were deemed positive if the Allred score was ≥ 3. The median age of the 59 patients with Papillary carcinoma was 58.0 years (range, 22-87 years), and the specimens were from 14 males and 45 females. The number of Papillary carcinoma specimens that were positive for BRAF (VE1), ER and PgR was 40 (68%), 2 (3%) and 32 (54%), respectively. For adenomatous goiter, positive scores were detected for BRAF (VE1), ER and PgR in 0 (0%), 1 (2%) and 12 specimens (26%), respectively. In patients with Papillary carcinoma, there was no difference in the number of BRAF (VE1)-positive and -negative specimens, according to sex or tumor diameter, although there were significantly more BRAF (VE1)-positive specimens from people ≥ 45 years, compared to those ＜ 45 years old. No BRAF (VE1)-positive expression was detected in adenomatous goiter, and BRAF (VE1) expression was specific for Papillary carcinoma. Our study suggests that BRAF (VE1) immunoexpression may be a useful marker for BRAF molecular targeted therapy for Papillary carcinoma in the near future.

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Acute kidney injury (AKI) is associated with poor prognosis. Continuous renal replacement therapy (CRRT) is used to treat patients with AKI who are hemodynamically unstable. However, the indication for starting and stopping CRRT, the optimal CRRT dose and the choice of anticoagulants are still controversial. This study aimed to investigate the current situation of AKI treated with CRRT at Showa University Fujigaoka Hospital. This was a single-center descriptive study which included all patients who were admitted to the intensive care unit from January through December 2010 and treated for AKI with CRRT. Patient characteristics and clinical outcomes were examined, and survivors and non-survivors were compared. The study included 43 patients, (mean age, 69 years), with the most common contributing factor for AKI being sepsis (44.2%). Before beginning CRRT, 20.9%, 16.3% and 62.8% of patients were AKI stage1, 2 and 3, respectively. Continuous hemodiafiltration was the most frequent method used (81.4%). The median CRRT dose was 16ml/kg/hr. Nafamostat mesilate was used as the anticoagulant in 42 patients (97.7%). The hospital mortality was 65.1%. There were significant differences between survivors and non-survivors for mechanical ventilation (8 vs. 24; P＝0.03), urine output (0.4 vs. 0.15ml/kg/hr; P＝0.01) and AKI stage (stage 1, 4 vs. 5; stage 2, 6 vs. 1; stage 3, 5 vs. 22, respectively; P＝0.002). We surveyed the current situation for AKI patients treated with CRRT at the hospital. Non-survivors had increased mechanical ventilation, decreased urine output and a more severe AKI stage at the start of CRRT, compared with survivors.

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Although three-incision laparoscopic appendectomy (3LA) is the standard method, use of single-incision laparoscopic appendectomy (single LA) has increased recently. However, in single LA the incision at the site of the umbilical portion is larger than the umbilicus size and it is necessary to use dedicated instruments. In our hospital, the two-incision laparoscopic appendectomy (2LA) method has been performed for nine patients. In all patients the appendectomy was successfully finished using the two-incision method with a smaller incision than the umbilicus. We retrospectively compared the operation outcomes of these patients with nine other patients who underwent 3LA in the same period. The hospital stay of the 2LA group was significantly shorter than the 3LA group. There were no significant differences between these two groups in other outcome factors. We suggest that 2LA is advantageous in that a small incision is used, especially for infants and young ladies, and it also offers easier maneuvering technique compared with single LA.

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We have adopted a special method to seal the dura mater using gelfoam and fibrin glue. Also we have developed a surgical technique to repair dura matter. Of 482 spinal operations performed since 2008, 3 cases had had dural lacerations during decompressive procedures. A conventional gelfoam of size 10×10×15mm is longitudinally sliced into three pieces, each 3.3mm in thickness. Each gelfoam piece is then soaked in fibrinogen solution. After that, we drip thrombin liquid to cover the gelfoam On top of the thrombin liquid, we place another gelfoam strip to make a tighter seal. For dural lacerations made during decompressive procedures, first we incise the dura mater and then we make small hole in the dura mater on the cranial side. We close the torn dura mater. Finally, we patch the dura mater using fibrin glue and the above-mentioned gelfoam. All of the cases except for three showed no signs of CSF leak. Two cases with lumbar stenosis had minor lacerations during the decompressive procedures. One case had schwanoma. We conclude that this closure method of the dura mater is clinically effective.

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The case is a 74-year-old woman. A medical examination at our hospital showed anemia and fecal occult bleeding. We did not recognize any abnormality by colonoscopy, but abdominal CT revealed a calculus (diameter 3cm) was admitted to the small intestine. She had a diagnosis of enterolith. Because there was no symptom, such as intestinal obstruction and she did not want aggressive treatment, she had a follow-up examination. Two months later, CT showed the intestinal calculus had moved to the anal side. The observation was continued, although after six months she developed ileus and then underwent emergency surgery. An advanced jejunum stenosis was revealed in operative findings. We thought that the bowel obstruction had developed due to incarceration of the calculus and thus we performed small intestine segmental resection including the narrow part. A circular ulcer was thought to be a stenosis. Histopathologically, it was revealed to be small intestine cancer. We encountered a case of small intestine cancer that was diagnosed with enterolith impaction and report the case with a discussion of the literature.

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A 36-year-old woman was admitted to our hospital because of a colicky right lower abdominal pain, diarrhea and vomiting during two weeks. Abdominal computed tomography (CT) showed a target-like appearance in the ascending colon, and the presence of a fat-density lesion. Colonoscopy revealed the presence of dark red invaginated mucosa at the transverse colon. The intussusception could be endoscopically repositioned. We diagnosed the patient as intussusception caused by an ascending colon lipoma, and performed right hemicolectomy by laparoscopic surgery. Operative findings showed that the tumor was located 5 cm distal to the ileocecal valve; the histological diagnosis confirmed the tumor to be a benign lipoma. We consider that endoscopy is useful for the repositioning and diagnosis of an adult intussusception and it could be considered a bridge to minimal invasive surgery. reposition and diagnosis for an adult intussusception and could be a bridge to minimal invasive surgery.

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Avulsion fractures of the tibial tubercle in adolescents are uncommon injuries. We report a case of tibial tuberosity avulsion fracture and arthroscopic surgery. A 17-year-old male was injured when hit by another player while playing basketball. The fracture type was type III based on the Watson-Jones Classification. Meniscal tear was suspected based on MRI findings. The fracture was fixed with three cannulated cancellous screws. At arthroscopic examination during surgery, no meniscal tear was observed. Three months after the surgery, the fracture showed union. The range of motion was full at the knee joint and also the patient had no trouble with daily life activities. It has been reported that the merger of meniscal tear in this type of fracture is rare. There is also a report that recommends meniscal repair, if the meniscus tear is suspected in the fracture type and if MRI seems to confirm the presence or absence of meniscal tear at arthroscopy.

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